Botulinumtoxin bei fokaler Hyperhidrose

Abstract

Eight years after its approval, intralesional injections of botulinum toxin type A have become established as an easily performed, highly effective and almost complication-free therapeutic option in primary axillary hyperhidrosis. Sweat production is decreased to about a sixth of previous amounts, and the effect persists for 7 months on average. Restoration of the often significantly impaired quality of life has been convincingly documented in large studies. The effect of botulinum toxin is based on the inhibition of the release of acetylcholine into the synaptic cleft. In addition to this approved use, botulinum toxin is also successfully employed in other forms of focal hyperhidrosis, particularly in gustatory sweating. However, its use in palmoplantar hyperhidrosis, the second most common form of primary hyperhidrosis, is limited because of the pain from numerous injections, need for increased doses of the expensive toxin and the relatively short effective period of about 4 months. Botulinum toxin type B appears to be comparably effective as type A products but is more often associated with systemic adverse events.

Repetitive injections of botulinum toxin A continuously increase the duration of efficacy in primary axillary hyperhidrosis: A retrospective analysis in 101 patients

“…The efficacy of botulinum toxin therapy has been demonstrated in several placebo‐controlled and double‐blinded studies . Treatment results in a decrease of sweat production to about one sixth of pre‐treatment values . While the therapeutic effect usually persists for 4 to 7 months , intervals between 2 and 24 months have been reported .…”

Botulinum Toxin Treatment of Autonomic Disorders: Focal Hyperhidrosis and Sialorrhea

“…and diseases affecting the neuromuscular system (e.g., myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis). 32 Treatment of pregnant and breast feeding women should be avoided even if there are no reports on fetal harm. 33 Women of reproductive age have to be advised to execute a reliable method of contraception and to not become pregnant within 6 months of injection.…”

Dermatological problems of the puberty

“…Treatment of excessive sweating is difficult and it frequently brings no expected results. Treatment includes antiperspirants (as the ready-to-use cosmetics or treatments containing aluminium chloride), cholinolytic drugs (Bellergot consisting of a mixture of ergot alkaloids, ergonovine and phenobarbital), clonidine, iontophoresis for sweating of feet and armpits, botulinum toxin, surgical methods (liposuction or curettage of sweat glands localised in armpits) and endoscopic thoracic sympathectomy (ETS) [ 54 , 55 ].…”